Effective treatments for both congenital and secondary lymphedema have been documented extensively in the medical literature. Multiple studies have documented the effectiveness of conservative lymphedema therapy, vascularized lymph node transfer, lymphaticovenous anastomosis, and suction-assisted protein lipectomy for properly selected patients with lymphedema.5–14 Vascularized lymph node transfer involves transfer of lymph nodes and the surrounding soft tissue as a microsurgical free flap from a donor site to the affected area. This technique is most effective for the treatment of fluid-predominant lymphedema, and can reduce the need for compression garment use and lymphedema therapy. Furthermore, vascularized lymph node transfer can improve patient quality of life and dramatically reduce the risk of dangerous lymphedema cellulitis in affected individuals.5–14
This case challenges the previous notion that the supraclavicular donor site is free from postoperative lymphedema risk. Careful patient selection and anatomical dissection, surgeon experience with the vascularized lymph node transfer procedure, and the use of reverse lymphatic mapping may reduce such donor-site risk.
The authors have no financial interest to declare in relation to the content of this article.
Ming Lee, A.B.
Evan McClure, B.A.
Erik Reinertsen, B.S.
Wallace H. Coulter Department of Biomedical Engineering
Jay W. Granzow, M.D., M.P.H.
Los Angeles, Calif.
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